Coupling of indigenous-patient-friendly cultural communications with clinical care guidelines for type 2 diabetes mellitus

Distance, terrain, climate and inadequate medical resources seriously constrain health care accessibility for rural and remote Indigenous communities of Western Australia (WA). Management of the Type 2 Diabetes Mellitus (T2DM), a chronic condition affecting Indigenous people much more than non-Indigenous, requires a complex assortment of time-sensitive communications activity and interventions to avert serious complications. Communications barriers arising from pervasive cultural misunderstanding in primary care go far beyond language differences and routine translation techniques. Practitioners and patients lacking the capability and capacity to facilitate dialogue for shared meaning in the examination and testing discourse need a culturally sensitive purpose-driven informatics system of support for the Patient-Practitioner Interview Encounter (PPIE). The dominant unidirectional clinician-biased forms of communication employed by healthcare professionals are a major barrier. Our developing communications support model utilizes the mapping of ontologies. The Community Healthcare ontology is dedicated to mapping a clinical taxonomy for T2DM national guidelines to Aboriginal English (AE). The eventual user interface will represent Aboriginal patient-culture-driven access to and use of interactive audio visual media in the primary healthcare setting.This research objective establishes value of and respect for the Aboriginal patient’s dialectal and pragmatic preferences, thereby enabling us to couple these preferences with Australia’s Standard English clinical communications practice in the treatment and care of IndigenousT2DM patients. A critical capability of the eventual application, especially when phrase ontology guidance enters the interface will be the interception of ambiguities and mitigation of misinterpretation risk. The emphasis is concentrated on bi-directional communications assistance that will not only enhance the Aboriginal patient opportunity to contribute to the PPIE, but will reinforce the value of and reciprocal respect for, sound clinical practice

Development of patient-practitioner assistive communications (PPAC) ontology for type 2 diabetes management

Communication in primary care is a key area of healthcare slow to adopt new technology to improve understanding between the patient and healthcare practitioner. Patients whose cultural background and regular form of dialectal communication are far removed from that of mainstream society are particularly disadvantaged by this during the patient-practitioner interview encounter (PPIE). In this paper, we present an assistive communications technology (ACT) framework for PPIE developed using a Type-2 Diabetes Management Patient-Practitioner Assistive Communications (T2DMPPAC) ontology in order to help both Aboriginal patient and non-Aboriginal practitioner optimise their pre-encounter, during-encounter and post-encounter communication. The T2DMPPAC architecture provides knowledge and presents it in a manner that is easily accessible and understood by the user (patients and practitioners) as well as accompanying carers, and as appropriate, interpreters. An example of bi-directional mapping of concepts to language during a PPIE session is shown using the ontology

An Aboriginal English Ontology Framework for Patient-Practitioner Interview Encounters

Current diagnosis, treatment and healthcare delivery processes in Australia are dominated by long established westernized clinically driven methods of patient-practitioner interaction. Consequently this dominant healthcare provider influence contributes to risk of miscommunication, misinformation in patient records and reciprocal misunderstandings that go unrecognised as such. For Indigenous communities, inadequate health literacy (HL) and a pervasive semantic disconnect are major barriers. Overcoming these barriers in the primary care setting presents opportunities to deliver appropriate timely and more effective care. We propose an e-health framework that enhances the Patient-Practitioner Interview Encounter (PPIE) through the use of a patient-centric linguistic interface using semantic mappings between Aboriginal English (AE) and Standard Australian English (SAE). This will ameliorate communications and interactions, so meeting the needs of all stakeholders (Patients, Physicians, Nurses, Allied Health Professionals and their Non-Critical Carers) engaged in Indigenous patient-centric primary care. It provides healthcare practitioners and their Indigenous T2DM patients with a new platform for two-way educative sharing and knowledge exchange that will increase mutually productive treatment, care and management expectations

Animism rather than Shamanism: new approaches to what shamans do (for other animists)

What shamans do is sometimes said to involve possession by spirits. However, shamanism has also been defined in opposition to spirit possession. This chapter proposes that approaching shamans and their activities, ideas and communities via the perspective provided by recent re-examination and re-definition of "animism" may improve and and enrich scholarly understanding and analysis of the activities and unvolvements of shamans

John Dewey and the Mind-Body Problem in the Context: The Case of «Neutral Monism»

The main focus of this paper is the mind-body problem in its relation to the doctrine of ‘neutral monism’ and the question who can be considered its proponents. According to Bertrand Russell, these are Ernst Mach, William James, and John Dewey (to name a few). This paper aims to clarify whether Russell himself was right in his conclusions or not. At first, I start with the clarification of the relation between ‘neutral monism’ and ‘dual-aspect theory’. Secondly, I analyze the ‘big three’ of the neutral monism: Mach, James and Russell. My starting-point here is Russell’s very understanding of Mach and James positions. In the end, it appears that neither Mach, nor James as well as Dewey can be considered as neutral monists. It was rather Russell’s misunderstanding of the both James’ radical empiricism and Mach’s analysis of sensations, which led him to the creation of his own original version of ‘neutral monism’ (or ‘Russelian monism’)

A Framework for Patient Practitioner Information Exchange

The global Type 2 Diabetes Mellitus (T2DM) epidemic imposes a heavy burden on communities that are ethnically vulnerable to the disease and further disadvantaged by socio-economic circumstance and cultural communications barriers. Aboriginal communities in rural and remote Western Australia are representative of these high-riskgroups. Indigenous patients needing continuous management of T2DM are also experiencing disproportionate risk of co-morbidities and hospitalizations compared with nonindigenous patients. Type 2 Diabetes Mellitus (T2DM) is often described as ’the lifestyle disease’. Within clinical care and patient quality of life management domains, T2DM presents both the healthcare practitioner and the patient with a mosaic of complexities.Information processing demands for self-management of diabetes are extensive, requiring constant self monitoring and assessment of the illness state in order to apply per instance and per condition the most appropriate form of control. In this work we introduce a primary care communications concept tool centered upon optimization of the Patient-Practitioner Interview Encounter (PPIE). The target beneficiary is the Aboriginal T2DM patient living in Western Australia. Avital part of our design effort is therefore dedicated to understanding and responding to the cultural domain barriers, challenges and opportunities of this specific health care environment

A critical discourse analysis of negotiations between business and Aboriginal peoples : implications for strategic management of crosscultural knowledge

The concept and use of knowledge in business studies is predominantly determined by a Western interpretation, with strategic management theory and practice positioning knowledge as a key factor in the creation of competitive advantage. The thesis examines Western and Aboriginal ways of knowing, and explores the presuppositions of knowledge in Western culture.Utilising critical theory the thesis has researched and penetrated the cultural interface between Aboriginal and non-Aboriginal people during business negotiations. The research is a first order interpretation by a non-Aboriginal researcher that critically analyses and unpacks the non-Aboriginal discourse of cross-cultural negotiations. The thesis reveals the impact of Western normative culture on the construction of cross-cultural knowledge.It is argued the current Western orientation of strategic management theory fails cross-cultural negotiations, and that ways of knowing outside the paradigm of traditional strategic management research can provide a broader understanding of knowledge and improve cross-cultural negotiations. The thesis argues that the models for understanding national cultures are Western orientated models that may have inherent cultural limits. The thesis draws upon frame theory, and argues that cultural schema and mental models known as frames have a significant impact on cross-cultural negotiations.The significance of the research resides in two primary areas. Firstly the literature regarding knowledge in strategic management is inclined to be positivist with a strong Western academic influence. This thesis argues that the literature and discipline of strategic management will be enriched by a more heterogenous approach to knowledge through a diversity of research paradigms, and through understanding other cultural approaches to knowledge. This thesis contributes through an interpretive perspective to strategic management theory and practice.Secondly the research contributes to the literature, theory and practice of cross-cultural negotiations. Specifically there is a paucity of literature on Aboriginal and non- Aboriginal negotiations, and this thesis through the critical discourse analysis of negotiations provides a significant insight into this cultural interface. Frame theory assists understanding how non-Aboriginal negotiators make meaning during cross-cultural negotiations and how this influences their understanding of knowledge.The thesis concludes with two key recommendations. Firstly that strategic management research, theory and practice will be well served by a broader approach to knowledge. This will be achieved by recognising that a positivist approach to research in strategic management has limitations, and the management models of knowledge have culturally imbued presuppositions or schema that frame our interpretation of ways of knowing. Secondly two models for cross-cultural negotiations are proposed. The models recommend that we suspend our own constructs of reality to engage with other ways of knowing in a reflective process to generate new schemas of knowledge

Governing sex: removing the right to take responsibility

The Commonwealth Intervention of 2007 in the Northern Territory largely missed its ostensible aim of protecting sexually abused children, argues this essay which examines the relevant social, cultural and historical factors based on specific ethnographic work. Abstract The exposure in 2006 of horrific cases of sexual violence that allegedly characterised Northern Territory Aboriginal communities, evoked responses dominated by a predictable moral panic. Thus the Commonwealth Intervention of 2007 largely missed its ostensible aim of protecting sexually abused children. This essay moves beyond a moralising analysis to consider relevant social, cultural and historical factors based on specific ethnographic work. First I present a sense of some profound historically established differences and common themes in traditional Aboriginal and mainstream law in relation to the regulation of sexuality. Then I draw on evidence that Aboriginal people embraced the notion of ‘two laws’, even as the new era created profound difficulties in relation to sexual norms. Their ‘right to take responsibility’ (Pearson 2000) was further undermined by ‘Interventions’ that unashamedly diminished the ability of NT Aborigines to govern their own communities. Finally, mainstream institutions that are deeply engaged with Aboriginal communities need to consider the ways they may be perpetuating entrenched difficulties

The Denazification of MH: The Struggle with Being and the Philosophical Confrontation with the Ancient Greeks in Heidegger’s Originary Politics

James T. Hong’s experimental documentary, The Denazification of MH (2006) is neither an apology for Heidegger’s involvement with National Socialism nor a condemnation of that involvement. Rather, the film is a critical philosophical confrontation (Auseinandersetzung) with Heidegger’s thought and the issue of his involvement with National Socialism. The film addresses the perennial concern as old as philosophy itself: the relationship between the philosopher’s life and his philosophy. While the film does not adopt a definitive position regarding Heidegger, Nazism, and the issue of personal responsibility, it does suggest an affirmative response to the question posed by both Levinas and Blanchot regarding the possibility of philosophizing after Auschwitz